초록접수 현황
| 20F-105 | Video session발표 |
Thoracoscopic Anterior Mediastinal Mass Removal using Articulating Laparoscopic instrument (Artisential)
Jeong In Hong, Kook Nam Han, Hyun Koo Kim, Young Ho Choi
Department of Thoracic and Cardiovascular Surgery, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Republic of Korea
Purpose : The recent development of technology enables the free articulating movement of endoscopic instruments even during thoracoscopic surgery. We performed thoracoscopic anterior mediastinal mass removal using articulating laparoscopic instruments (Artisential). We evaluated its feasibility and safety or technical limitations during procedure.
Methods : The patient was a 28-year old male with an anterior mediastinal tumor suspecting teratoma. The patient was positioned in the left semi-lateral decubitus (30 degrees) and one-lung ventilation anesthesia. We inserted three 12-mm trocars at 6th intercostal space (ICS) along the mid-clavicular line, and 4th and 5th ICS along the anterior axillary line. CO2 gas insufflation with 6~10mmHg was done to acquire enough operative field. Fenestrated forceps and bipolar Maryland dissectors or energy devices were introduced through the ports.
Results : Anterior mediastinal mass could be dissected with enough resection margin and all vessels connected to mass were ligated with articulating clip applier.
These articulating instruments made us do the whole procedure easier especially when the target lesion was placed deep and sharp-angled, which needed an angulated movement of the instrument.
Operation time was 62 minutes and subcutaneous emphysema was developed but solved without any intervention. The chest drain was removed at postoperative 2 days and the patients discharged at postoperative 4 days.
Conclusion : The articulating laparoscopic instruments were useful especially when the target lesion was placed difficult to approach with conventional instruments, although the learning curve is needed to handle this instrument.
Methods : The patient was a 28-year old male with an anterior mediastinal tumor suspecting teratoma. The patient was positioned in the left semi-lateral decubitus (30 degrees) and one-lung ventilation anesthesia. We inserted three 12-mm trocars at 6th intercostal space (ICS) along the mid-clavicular line, and 4th and 5th ICS along the anterior axillary line. CO2 gas insufflation with 6~10mmHg was done to acquire enough operative field. Fenestrated forceps and bipolar Maryland dissectors or energy devices were introduced through the ports.
Results : Anterior mediastinal mass could be dissected with enough resection margin and all vessels connected to mass were ligated with articulating clip applier.
These articulating instruments made us do the whole procedure easier especially when the target lesion was placed deep and sharp-angled, which needed an angulated movement of the instrument.
Operation time was 62 minutes and subcutaneous emphysema was developed but solved without any intervention. The chest drain was removed at postoperative 2 days and the patients discharged at postoperative 4 days.
Conclusion : The articulating laparoscopic instruments were useful especially when the target lesion was placed difficult to approach with conventional instruments, although the learning curve is needed to handle this instrument.
책임저자: Hyun Koo Kim
Department of Thoracic and Cardiovascular Surgery, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Republic of Korea
발표자: Younggi Jung , E-mail : jeonginhannahh@gmail.com